Thyroiditis refers to inflammation of the thyroid gland. This can cause pain and discomfort in the neck area where the thyroid gland is located. The thyroid gland sits at the front of the neck, just below the larynx (voice box) and wraps around the front and sides of the trachea (windpipe). When the thyroid becomes inflamed, it can put pressure on the surrounding tissues and nerves, leading to pain. Let’s look at some quick answers to common questions about neck pain and thyroiditis:
How do you know if neck pain is from thyroiditis? Neck pain from thyroiditis often feels like a dull, aching pain or pressure on one or both sides of the neck where the thyroid gland sits. The pain may worsen with swallowing or turning the neck. Other symptoms like fever, fatigue, and throat swelling often accompany the pain.
What are the common causes of thyroiditis? The most common causes are autoimmune disorders like Hashimoto’s thyroiditis or viral infections. Other less common causes include radiation exposure, pregnancy, and certain medications. Blood tests help diagnose the underlying cause.
When should I see a doctor for neck pain with thyroiditis? See your doctor if neck pain persists for more than 1-2 weeks or is severe. Also see your doctor if the pain comes with breathing problems, difficulty swallowing, hoarse voice, or high fever. These can signal serious complications that need medical care.
How is thyroiditis with neck pain treated? Treatment focuses on addressing the underlying inflammatory cause. Your doctor may prescribe thyroid hormone replacements, anti-inflammatory drugs, antivirals, or observation alone. Rarely is surgery needed for thyroiditis neck pain.
What Areas of the Neck Are Affected by Thyroiditis?
The thyroid gland consists of two lobes, located on either side of the lower front of the neck. Areas commonly affected by thyroiditis include:
Anterior neck: The front of the neck overlying the thyroid gland often feels sore and tender to touch when inflamed. Pain usually starts in one lobe but can spread along the front of the neck as inflammation worsens.
Lateral neck: The outer areas of the neck along the sides may ache as the inflamed thyroid gland swells and puts pressure on nearby structures. The lateral pain may radiate up towards the jaw and ears.
Throat and larynx: The swollen thyroid gland can cause a feeling of pressure, fullness, or pain in the front of the neck and throat area. This can cause difficulty and pain with swallowing.
Upper chest: In some cases, the inflammation extends downwards and can cause upper chest discomfort. The chest pain is often described as an aching sensation along the top of the breastbone.
Common Causes of Neck Pain with Thyroiditis
Here are some of the most common causes of neck pain related to thyroid inflammation:
Hashimoto’s Thyroiditis
This is the most common cause of thyroiditis neck pain. Hashimoto’s disease is an autoimmune disorder causing chronic inflammation of the thyroid gland. The immune system mistakenly attacks and slowly destroys thyroid tissue. This leads to widespread inflammation and enlargement of the thyroid, putting pressure on surrounding neck structures.
Subacute Thyroiditis
Also known as subacute granulomatous thyroiditis or de Quervain’s thyroiditis, this condition causes very painful inflammation of the thyroid. It often follows a viral upper respiratory infection. The thyroid becomes enlarged, hard, and extremely tender. Neck pain usually starts and is most severe on one side.
Postpartum Thyroiditis
Up to 10% of women develop inflammation of the thyroid in the year after giving birth. The swollen, inflamed gland leads to moderate neck soreness and tenderness, usually 6-8 months after delivery. Other postpartum symptoms often accompany the neck pain.
Acute Thyroiditis
This rare form of thyroiditis arises from a bacterial infection in the thyroid gland. The thyroid becomes acutely swollen and painful as pus accumulates in the infected gland. Patients often have a high fever, exquisite neck tenderness, and systemic illness.
Silent Thyroiditis
Also called painless thyroiditis, this condition involves thyroid inflammation and damage without significant neck pain. Some mild soreness and tenderness may occur but not to the degree expected with the extent of inflammation. The thyroid dysfunction usually resolves on its own.
Radiation Thyroiditis
Prior exposure to radiation therapy in the neck region can cause delayed damage and inflammation of the thyroid gland. The thyroiditis may develop months or years later, causing mild pain and tenderness in the neck.
Location of Discomfort
The location of neck discomfort can provide clues as to which part of the thyroid gland is most affected:
Left vs. Right Side Pain
Unilateral pain on the left or right side of the neck indicates one thyroid lobe is more inflamed than the other. Hashimoto’s thyroiditis often starts as one-sided pain before spreading. Subacute thyroiditis classically begins as severe unilateral pain before becoming bilateral.
Upper Neck Pain
Inflammation in the upper portion of the thyroid lobes may refer pain upwards towards the lateral neck by the jawbone and ears. Patients may feel some radiating pain into the occipital region in the back of the head.
Lower Neck Discomfort
Soreness in the lower neck is typical with inflammation of the lower thyroid lobes. The pain and tenderness may extend downwards over the upper chest and top of the breastbone. Difficulty swallowing often accompanies lower neck thyroiditis discomfort.
Central Neck Ache
Sometimes the thyroid pain is more generalized and involves the entire front of the neck. This indicates widespread inflammation of both lobes and isthmus of the thyroid gland. The central neck ache may make it uncomfortable to move the neck or swallow.
Quality and Severity of Pain
Doctors also characterize thyroiditis neck discomfort based on the quality and severity of pain:
Dull, Aching Pain
Chronic forms of thyroiditis like Hashimoto’s disease cause more of a dull, throbbing neck ache versus acute stabbing pains. The achy discomfort typically worsens with neck motion and swallowing.
Sharp, Stabbing Pain
Sudden onset neck pain with a piercing, stabbing quality points more towards acute thyroiditis. Turning the neck or swallowing may trigger episodes of more severe, sharp pains.
Mild Discomfort
Some forms of thyroiditis like postpartum thyroiditis or painless thyroiditis cause only mild throat discomfort and neck tenderness without significant pain. The inflammation is evident on tests but not as painful.
Severe, Excruciating Pain
Subacute thyroiditis classically causes some of the most severe neck pain of any thyroid condition. The thyroid gland becomes extremely tender to light touch. Patients have difficulty turning their neck due to intense unilateral pain.
When to See a Doctor
You should make an appointment to see your doctor if you have any of the following:
– Moderate to severe neck pain lasting more than 1-2 weeks
– Pain accompanied by difficulty swallowing or shortness of breath
– Very tender neck swelling or lumps in the neck
– Unexplained hoarseness lasting over 2 weeks
– Thyroid neck pain along with other concerning symptoms like fever, weight loss, racing heart rate, or tremors
Prompt medical evaluation is important to determine if thyroiditis is causing your neck pain and to avoid complications. Thyroiditis can sometimes progress rapidly, leading to problems like tracheal compression or thyroid storm. Your doctor can order appropriate blood tests and imaging like neck ultrasound or thyroid uptake scans to diagnose the problem. Early treatment helps resolve the inflammation and pain more quickly.
Physical Exam Findings
When you see the doctor for possible thyroiditis neck pain, they will perform a focused physical exam of your head and neck region. They will look for key exam findings that are typical with an inflamed, enlarged thyroid gland. Here are some of the most common physical exam features of thyroiditis:
Thyroid enlargement or nodules – Diffuse thyroid enlargement or discrete nodules may be visible or palpable in the front of the neck. The thyroid often appears swollen and bumpy.
Tenderness of the thyroid gland – The doctor will palpate the neck to check for pain and tenderness over the thyroid, a classic finding. Even light touch can trigger discomfort.
Redness or warmth – The skin overlying the inflamed thyroid may look red and warm to the touch. This indicates increased blood flow to the area.
Swollen lymph nodes – Enlarged, tender lymph nodes are commonly felt in the neck region near the inflamed thyroid gland. This signals the body’s immune response.
Tracheal deviation – If thyroid swelling is pronounced, the windpipe may be pushed to one side. This tracheal deviation is more common with large goiters.
Hoarse, weak voice – Pressure on the recurrent laryngeal nerves from thyroid enlargement can cause vocal changes like hoarseness.
Difficulty swallowing – Discomfort or pain with swallowing, especially when drinking liquids, can occur as the swollen thyroid compress the esophagus.
Diagnostic Testing
If thyroiditis is suspected based on neck exam findings, your doctor will likely order some laboratory tests and imaging to confirm the diagnosis and determine the cause. Common diagnostic approaches include:
Blood Tests
– Thyroid function tests (TSH, T3, T4) to assess thyroid hormone levels
– Thyroid antibodies testing for Hashimoto’s disease
– Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) to detect inflammation
– Complete blood count to check for infection
Ultrasound of the Neck
This imaging test uses sound waves to create detailed pictures of the thyroid gland. It can show areas of inflammation and nodularity.
Radioiodine Uptake Scan
You ingest a small dose of radioactive iodine. Imaging tracks uptake in the thyroid to evaluate areas of inflammation versus normal functioning.
Fine Needle Aspiration Biopsy
A thin needle extracts samples of thyroid cells for examination under the microscope. This helps differentiate between various causes of thyroiditis.
Treatment Options
The treatment plan depends on the specific type and cause of the thyroiditis:
NSAIDs – Non-steroidal anti-inflammatory drugs like ibuprofen can help alleviate pain and inflammation.
Corticosteroids – Prescription steroids such as prednisone may be used for short periods to reduce severe thyroid inflammation and pain.
Thyroid hormone therapy – Levothyroxine is often prescribed if thyroid hormones levels are low to prevent hypothyroidism symptoms.
Beta blockers – May be helpful for hyperthyroidism symptoms until thyroid function normalizes.
Antibiotics – Used for infectious thyroiditis to treat the underlying bacterial infection.
Watchful waiting – Mild cases may just be monitored with symptom relief until the thyroiditis resolves.
Home Remedies and Lifestyle Changes
Along with medical treatment, these self-care tips can help manage thyroiditis neck discomfort:
– Use cold compresses or ice packs on the sore neck area for 15-20 minutes several times per day to reduce inflammation.
– Take over-the-counter pain relievers like acetaminophen as needed for neck pain and sore throat.
– Drink lots of fluids and stay well hydrated. This keeps mucus thin to avoid irritating an inflamed throat.
– Gargle with warm salt water to ease throat discomfort and loosen mucus.
– Rest your voice if it becomes hoarse. Avoid yelling or straining your vocal cords.
– Sleep with extra pillows to keep your head and neck comfortably elevated.
– Wear loose fitting clothing around your neck to avoid irritation and rubbing.
– Practice stress-reducing techniques like yoga, meditation, or therapeutic massage for overall wellbeing.
When to Seek Emergency Care
In rare cases, thyroiditis may cause potentially life-threatening complications that require emergency medical care:
Difficulty breathing – Go to the ER if you have airway obstruction or struggle to get enough air. A hugely enlarged thyroid (severe goiter) can sometimes compress the windpipe.
Thyroid storm – Seek immediate help if you have a high fever over 100°F, racing heartbeat, tremors, nausea, diarrhea, or confusion. This thyroid crisis is a medical emergency.
Vocal changes – Rapid development of a very hoarse voice or complete loss of voice should be evaluated urgently. This indicates potential vocal cord paralysis.
Difficulty swallowing – Inability to swallow any liquids should prompt emergency care. It could mean a paralyzed esophagus not moving food properly.
Go straight to the emergency room if you have any signs of the above complications for rapid diagnosis and treatment. Prompt medical intervention can prevent catastrophic outcomes like suffocation or cardiovascular collapse in rare cases.
Prevention Tips
While thyroiditis sometimes develops unavoidably, the following healthy habits may help lower your risk:
– Avoid respiratory infections when possible, especially if you are prone to subacute thyroiditis.
– Treat any bacterial infections quickly with antibiotics if recommended by your doctor.
– Maintain good control of autoimmune conditions like Type 1 diabetes that are associated with Hashimoto’s thyroiditis.
– Don’t smoke and limit alcohol intake which can aggravate autoimmune thyroid disease.
– Stay up to date on vaccines like influenza to prevent viral illnesses linked to painful thyroiditis flares.
– Take thyroid hormone replacement medication reliably every day if prescribed for hypothyroidism.
– Discuss iodine supplements with your doctor if you have a mild iodine deficiency that could strain the thyroid.
– Consider discussing thyroiditis prevention with your doctor if you have family members with a history of the condition.
Conclusion
Thyroiditis neck pain results from inflammation of the thyroid gland in conditions like Hashimoto’s and subacute thyroiditis. The location, quality, and severity of pain provides clues to the underlying cause. See your doctor promptly for neck pain lasting over 1-2 weeks to get a diagnosis and appropriate treatment. With proper medical care and self-care techniques, thyroiditis pain usually gradually resolves as the inflammation clears. Rarely do complications arise requiring emergency care. Prevention centers around maintaining thyroid health through healthy lifestyle habits and immune modulating therapies in susceptible individuals.